The author is a Forbes contributor. The opinions expressed are those of the writer.

Loading ...

Loading ...

This story appears in the {{article.article.magazine.pretty_date}} issue of {{article.article.magazine.pubName}}. Subscribe

In the weeks after the passing of iconic orthopedic surgeon Dr. Frank Jobe, his innovative ulnar collateral ligament surgery has unfortunately become a topic of constant conversation throughout spring training camps in Arizona and Florida. As the Arizona Diamondbacks, Atlanta Braves and Oakland Athletics potentially deal with the losses of four starting pitchers to season ending surgeries, Major League Baseball and its 30 ball clubs are reminded once again of the harsh realities regarding the fragility of a pitcher’s elbow. It appears as if Brandon Beachy, Patrick Corbin, Kris Medlen and Jarrod Parker must prepare for at least a year away from baseball after surgery and a new series of solitary challenges that will accompany the pain that is synonymous with rehabilitation.

Recently, the Society for American Baseball Research (SABR) concluded its third annual Baseball Analytics Conference in Phoenix, Arizona. Instead of beginning the three day conference with a panel discussion on the relevance of Weighted On-Base Average (wOBA) and how it can be used in evaluating an offensive player’s overall value, the hundreds in attendance were pleasantly surprised to see a panel on medical analysis and injury prevention. ESPN’s Buster Olney moderated the hour long discussion with Dr. Stan Conte of the Los Angeles Dodgers, Dr. Glenn Fleisig of the American Sports Medicine Institute and Chris Marinak of Major League Baseball. Olney began by commenting on how the New York Mets had carefully monitored Matt Harvey’s pitch counts and innings limits, but he still sustained a serious injury and is currently recovering from surgery to a partially torn ulnar collateral ligament in his right elbow.

One of the initial questions that had arisen based on the Harvey example pertained to the relevance of major league franchises monitoring pitch counts and innings limits for its pitchers. Dr. Conte took the conversation in a different direction for a moment and refocused it on the number of “Tommy John” surgeries that were occurring on a yearly basis. According to Dr. Conte, 18-20 pitchers undergo the surgery on a yearly basis at the major league level and it is rather consistent. The only anomaly had occurred in 2012 when the surgeries had actually doubled, but it has recently returned to its normal average.

Dr. Conte and Dr. Fleisig both made it abundantly clear that pitch counts and innings limits are important parts of the equation, but aren’t the only factors used to evaluate a pitcher’s health and susceptibility to injury. They can’t tell you with great certainty when or if a pitcher will break down due to an injury or poor mechanics. A heavy emphasis was placed on the value of intimately understanding a pitcher’s mechanics and how it coincides with the overall evaluation process. In truth, the mechanics of a pitcher are far more important than the amount of four seam fastballs thrown for strikes in a high leverage inning. Dr. Fleisig reminded the captivated audience that creating a mathematical equation doesn’t always work and that pitchers are human beings. Each pitcher is unique in nature and possesses a wide array of varying skill levels, thresholds for pain and idiosyncrasies.

Both doctors agreed that pitch counts and innings limits should be viewed as a guideline at the major league level and the feedback provided by the medical staff is critical in evaluating a pitcher’s progress. Dr. Conte is of the belief that one should pay closer attention to changes that occur in pitch counts over time. He also wondered aloud how the number “100” became the unofficial threshold for pitch counts throughout the game of baseball. Dr. Conte assumed the origins of the number began with the book written by Craig R. Wright and former major league pitcher Tom House entitled, “The Diamond Appraised,” in 1989.

Ligaments of the elbow (Photo credit: Wikipedia)

A topic of great interest discussed by the panelists involved stressful innings. Depending upon who you talk to, stressful innings can be defined by high pitch counts or in game situations that can elevate a pitcher’s discomfort. For instance, scenarios such as first and third nobody out and bases loaded with less than two outs. Dr. Conte referred to the importance of analyzing leverage indexes and seeing if a correlation exists to injuries amongst pitchers. According to Dr. Conte, the Los Angeles Dodgers’ definition of stressful innings is achieved when a pitcher throws more than 23 pitches in an inning. The merger of baseball statistics and medical information is essential in the treatment of pitchers as the advancements in technology progress in the coming years.

Marinak, Vice President of League Economics and Strategy for Major League Baseball, admitted that injury and medical research within the game of baseball is at its infancy stages. Many people believe that injury analysis is the next unchartered frontier within the analytics community. When Marinak joined Major League Baseball in 2008, a system wasn’t in place to track injury or medical information of ball players. It was simply a paper document and filing cabinet mentality that lacked vision when it came to future research projects and overall medical care. In collaboration with the Major League Baseball Players Association in 2010, Major League Baseball finally created an electronic medical records system. In some instances, medical data now exists for ball players going back almost a decade.

With the creation of a database that tracks concussions, collisions, and even ulnar collateral ligament surgeries, Major League Baseball has a new perspective on injury analysis. However, misperceptions still exist within the media and with sports fans. Injuries to pitchers are the most significant in terms of time lost within Major League Baseball. In a study yet to be published by Dr. Conte, pitchers come back and lose ¾ of a mile on average during their first year post “Tommy John” surgery.

Dr. Fleisig referred to a long term study of 1,000 pitchers with 800 from follow ups thanks to Dr. James Andrews that ranged from youth to the professional level. The study concluded that 85% of the participants returned to the same level of performance within 12 months. The study also concluded that over a year and a half, a pitcher was achieving a similar statistical level prior to surgery. Dr. Conte was quick to point out that in the same study the percentage that was isolated specifically to major league pitchers was 74% and their return had occurred in approximately 16 months.

As pitchers Corbin, Medlen and Parker deal with the unfortunate circumstances involving elbow injuries and the potential of season ending surgeries, questions have arisen throughout the sport regarding the injuries and how they had occurred in the first place. Is it overuse? Is it poor mechanics? Is it a combination of both? If one were to take a closer look at each of the previously mentioned starting pitchers and a few statistics of interest from the 2013 season, there are some similarities that might help in the overall analysis.

Pitcher

Games

100 or More Pitches

Maximum

Kris Medlen

32

12

116

Patrick Corbin

32

15

113

Jarrod Parker

32

9

117

Source: Baseball-Reference.com

Pitcher

IP

P/IP

Pitches Thrown

Kris Medlen

197.0

15.33

3,020

Patrick Corbin

208.1

14.70

3,060

Jarrod Parker

197.0

14.99

2,954

Source: Baseball-Reference.com

Please note: The Major League Baseball average P/IP in 2013 was 16.26 for 679 pitchers

After spending time analyzing the pitches thrown by the aforementioned starting pitchers in 2013, certain similarities are immediately obvious to the untrained eye. Corbin, Medlen and Parker relied heavily on throwing sinkerballs last season. Each starting pitcher threw over 1,200 sinkerballs with a frequency that easily eclipsed 40%. Besides the extraordinary amount of sinkerballs thrown last season by the three starting pitchers, each of the other statistics analyzed seem to be within moderation. Therefore, does it become an issue of mechanics rather than overuse?

Pitcher

Sinkerballs

Velocity

Frequency

Most Thrown in a Game

Kris Medlen

1,236

89.31

40.93%

55

Patrick Corbin

1,331

92.02

43.40%

65

Jarrod Parker

1,323

91.32

44.79%

65

Sources: Baseball-Reference.com and BrooksBaseball.net

Another item worthy of discussion and further analysis pertains to the three pitchers and leverage. The following chart summarizes the Average Leverage Index (pLI) over the past two seasons. A neutral situation is represented by the number one while anything below one indicates a less than stressful situation and anything above a one reflects a situation that is more stressful than the average. As you can see, each pitcher experienced noticeable increases in their Average Leverage Indexes between the 2012 and 2013 seasons.

Pitcher

2012

2013

Kris Medlen

0.81

1.01

Patrick Corbin

0.84

0.99

Jarrod Parker

0.96

1.01

Source: FanGraphs.com

Beachy has had a difficult time staying healthy over the past two years. In June 2012, he underwent “Tommy John” surgery and made his first major league start after surgery on July 29, 2013. Unfortunately, Beachy had only started five games in 2013 and his season ended with an arthroscopic surgery to his elbow. His outlook for the 2014 season doesn’t look promising at the present moment.

One of the key factors to consider when evaluating injuries to pitchers is the amount of money involved in the game of baseball and its effect on the decision making process. Does a pitching coach really want to tweak a pitcher’s mechanics and cost them the opportunity to sign a contract that could potentially provide them with financial security for the rest of their life? Can a coaching staff identify a fatal flaw in a pitcher’s mechanics, but are afraid to make the necessary adjustments since the pitcher has already achieved a high level of success to date? Are certain pitchers viewed as ticking time bombs and future candidates for surgery based solely on their mechanics?

Kris Medlen of the Atlanta Braves is 28 years old and just had his second “Tommy John” surgery in three and half years. Jarrod Parker of the Oakland Athletics is 25 years old and is on the verge of having his second “Tommy John” surgery since 2009. According to Dr. Conte, there were seven revisions of the “Tommy John” surgery in 2012. Surprised by the number of revisions that had occurred in such a short period of time, Dr. Conte had reviewed previous revisions and identified that only 17 had been performed on major league pitchers since 1991.

Doctors and Major League Baseball are now viewing the “Tommy John” surgery from two different perspectives: the length of time between surgeries for a pitcher and the increase in the amount of surgeries due to the medical advancements and overall success of the procedure. The length of time between surgeries is broken into two distinct categories: a period between surgeries that exceeds seven years and the surgeries or rehabilitation that fail within two years of the first procedure. Pitchers such as Brian Wilson and Joakim Soria have become synonymous with the revision in the “Tommy John” surgery. In Wilson’s case, the gap between surgeries was approximately eight years and it was almost nine years in the case of Soria.

In the days ahead, final verdicts will be rendered on the likes of Patrick Corbin and Brandon Beachy while Jarrod Parker prepares for yet another procedure. Matt Harvey has recently expressed his growing frustrations with the rehabilitation process and its isolation. Even with the medical advancements pertaining to the ulnar collateral ligament surgery, a pitcher’s mechanics is still at the forefront of the conversation. All of the PITCH f/x data and detailed analyses cannot change the fact that everything begins with mechanics.

Wayne G. McDonnell, Jr., B.B.A., M.B.A. is a Clinical Associate Professor of Sports Management, NYU School of Continuing and Professional Studies (NYU-SCPS) Preston Robert Tisch Center for Hospitality, Tourism, and Sports Management. Professor McDonnell is also a Co-Director, Program Development and Special Initiatives for New York University’s Sports and Society Program. He is a highly sought-after commentator and analyst on the game of baseball. McDonnell regularly appears on various television and radio programs including “Prime 9” on the MLB Network; coaches athletes as a private hitting and pitching instructor; and shares timely insights via the Twitter handle @wmcdonn25.